Response-Guided Therapy for Chronic Hepatitis C Virus Infection in Patients Coinfected with HIV: A Pilot Trial
Background. To study the feasibility of a response-guided therapy for chronic hepatitis C virus (HCV) infection in patients coinfected with human immunodeficiency virus (HIV) in a tertiary care hospital. Methods. Treatment duration was individualized on the basis of week 4 and week 12 virologic resp...
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| Veröffentlicht in: | Clinical infectious diseases 2009-04, Vol.48 (8), p.1152-1159 |
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| creator | Van den Eynde, Eva Crespo, Manuel Esteban, Juan I. Jardi, Rosend Ribera, Esteban Carbonell, Judit Rodríguez-Frias, Francisco Falco, Vicenç Curran, Adrià Imaz, Arkaitz Villar del Saz, Sara Ocaña, Inma Esteban, Rafael Pahissa, Albert |
| description | Background. To study the feasibility of a response-guided therapy for chronic hepatitis C virus (HCV) infection in patients coinfected with human immunodeficiency virus (HIV) in a tertiary care hospital. Methods. Treatment duration was individualized on the basis of week 4 and week 12 virologic response. Sixty patients were enrolled and received pegylated interferon alfa-2b (1.5 μg/kg per week) plus weight-based ribavirin (800–1400 mg/day). Patients who achieved a rapid virologic response, defined as viral load |
| doi_str_mv | 10.1086/597470 |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_755141921</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>40308975</jstor_id><oup_id>10.1086/597470</oup_id><sourcerecordid>40308975</sourcerecordid><originalsourceid>FETCH-LOGICAL-c484t-b006e99e82b9ee5c4b85792e5b236ea0aa15dbf740e41455cc13b6c1de0b08023</originalsourceid><addsrcrecordid>eNp10GGLFCEYB_Ahiu666hsUFlSvpnRGR-3dsdTt0kJHbEvcG3GcZ1i3WZ3Uoe7b5zXLBkGvFP8_HvVfFE8JfkuwaN4xySnH94pzwmpeNkyS-3mPmSipqMVZ8SjGPcaECMweFmdEVpxRWZ0X7gvE0bsI5dVkO-jQZgdBj7eo9wEtdsE7a9ASRp1sshEt0NaGKaKV68Ek6x2yDl3nEFzKqbd_zvOYnzbt0HK1fY8u0bUdfEKbYPXwuHjQ6yHCk-N6UXz9-GGzWJbrz1erxeW6NFTQVLYYNyAliKqVAMzQVjAuK2BtVTegsdaEdW3PKQZKKGPGkLptDOkAt1jgqr4o3sxzx-B_TBCTOthoYBi0Az9FxRkjNLdAsnz5j9z7Kbj8OFURKRvCuczo9YxM8DEG6NUY7EGHW0Wwuutfzf1n-Pw4bWoP0P1lx8IzeHUEOho99EE7Y-PJ5QdV-T937sXs_DT-_7Jns9nH5MNJUVxjITnLeTnnNib4dcp1-K4aXnOmlt9uVCXXkmy2n9RN_Rtajq2S</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>219961779</pqid></control><display><type>article</type><title>Response-Guided Therapy for Chronic Hepatitis C Virus Infection in Patients Coinfected with HIV: A Pilot Trial</title><source>Jstor Complete Legacy</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Van den Eynde, Eva ; Crespo, Manuel ; Esteban, Juan I. ; Jardi, Rosend ; Ribera, Esteban ; Carbonell, Judit ; Rodríguez-Frias, Francisco ; Falco, Vicenç ; Curran, Adrià ; Imaz, Arkaitz ; Villar del Saz, Sara ; Ocaña, Inma ; Esteban, Rafael ; Pahissa, Albert</creator><creatorcontrib>Van den Eynde, Eva ; Crespo, Manuel ; Esteban, Juan I. ; Jardi, Rosend ; Ribera, Esteban ; Carbonell, Judit ; Rodríguez-Frias, Francisco ; Falco, Vicenç ; Curran, Adrià ; Imaz, Arkaitz ; Villar del Saz, Sara ; Ocaña, Inma ; Esteban, Rafael ; Pahissa, Albert</creatorcontrib><description>Background. To study the feasibility of a response-guided therapy for chronic hepatitis C virus (HCV) infection in patients coinfected with human immunodeficiency virus (HIV) in a tertiary care hospital. Methods. Treatment duration was individualized on the basis of week 4 and week 12 virologic response. Sixty patients were enrolled and received pegylated interferon alfa-2b (1.5 μg/kg per week) plus weight-based ribavirin (800–1400 mg/day). Patients who achieved a rapid virologic response, defined as viral load <50 IU/mL at treatment week 4, completed 24 weeks of therapy. Patients who did not achieve a rapid virologic response were reassessed at treatment week 12. Patients with a complete early virologic response, defined as an HCV RNA level <600 IU/mL, were treated for 48 weeks. Patients with a partial response, defined as a decrease in the viral load ⩾2 log>10 and an HCV RNA level ⩾600 IU/mL, who attained an undetectable viral load at week 24 were treated for 60 weeks. The primary efficacy end point was sustained virologic response, defined as HCV RNA <50 IU/mL, 24 weeks after the end of treatment. Results. Overall, 33 (55%) of 60 patients achieved a sustained virologic response: 11 (44%) of 25 patients with HCV genotype 1, 3 (27%) of 11 patients with genotype 4, and 19 (79%) of 24 patients with genotype 3. One-third of patients showed a rapid virologic response. Of patients with genotype 1, there was a rapid virologic response in 4 (16%) of 25; with genotype 4, in 1 (9%) of 11; and with genotype 3, in 14 (58%) of 24. Of the 19 patients with a rapid virologic response, 17 (89.5%) eradicated the virus after 24 weeks of therapy. The rate of sustained virologic response was significantly higher among patients with genotype 3 and low pretreatment HCV RNA levels. A high relapse rate (46%) after 48 weeks of therapy occurred among patients infected with genotypes 1 or 4 who first achieved undetectable viral load at treatment week 12. Conclusion. A response-guide therapy is feasible and may be useful to optimize the individual outcome of HCV treatment in patients coinfected with HIV.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/597470</identifier><identifier>PMID: 19275492</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Oxford: The University of Chicago Press</publisher><subject>Adult ; Analysis of Variance ; Antiviral Agents - adverse effects ; Antiviral Agents - therapeutic use ; Biological and medical sciences ; Chi-Square Distribution ; Chronic hepatitis ; Feasibility ; Female ; Genotype ; Genotypes ; Hepacivirus - drug effects ; Hepacivirus - genetics ; Hepacivirus - isolation & purification ; Hepatitis ; Hepatitis C ; Hepatitis C virus ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - drug therapy ; Hepatitis C, Chronic - virology ; HIV ; HIV Infections - complications ; HIV/AIDS ; Hospitalization ; Hospitals ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infections ; Infectious diseases ; Interferon-alpha - adverse effects ; Interferon-alpha - therapeutic use ; Interferons ; Male ; Medical sciences ; Middle Aged ; Patients ; Pilot Projects ; Polyethylene Glycols - adverse effects ; Polyethylene Glycols - therapeutic use ; Recombinant Proteins ; Relapse ; Ribavirin - adverse effects ; Ribavirin - therapeutic use ; Ribonucleic acid ; RNA ; RNA, Viral - blood ; Statistics, Nonparametric ; Treatment Outcome ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral hepatitis ; Viral Load ; Virology ; Viruses</subject><ispartof>Clinical infectious diseases, 2009-04, Vol.48 (8), p.1152-1159</ispartof><rights>Copyright 2008 Infectious Diseases Society of America</rights><rights>2009 by the Infectious Diseases Society of America 2009</rights><rights>2009 INIST-CNRS</rights><rights>Copyright University of Chicago, acting through its Press Apr 15, 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-b006e99e82b9ee5c4b85792e5b236ea0aa15dbf740e41455cc13b6c1de0b08023</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/40308975$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/40308975$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,57992,58225</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21324552$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19275492$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van den Eynde, Eva</creatorcontrib><creatorcontrib>Crespo, Manuel</creatorcontrib><creatorcontrib>Esteban, Juan I.</creatorcontrib><creatorcontrib>Jardi, Rosend</creatorcontrib><creatorcontrib>Ribera, Esteban</creatorcontrib><creatorcontrib>Carbonell, Judit</creatorcontrib><creatorcontrib>Rodríguez-Frias, Francisco</creatorcontrib><creatorcontrib>Falco, Vicenç</creatorcontrib><creatorcontrib>Curran, Adrià</creatorcontrib><creatorcontrib>Imaz, Arkaitz</creatorcontrib><creatorcontrib>Villar del Saz, Sara</creatorcontrib><creatorcontrib>Ocaña, Inma</creatorcontrib><creatorcontrib>Esteban, Rafael</creatorcontrib><creatorcontrib>Pahissa, Albert</creatorcontrib><title>Response-Guided Therapy for Chronic Hepatitis C Virus Infection in Patients Coinfected with HIV: A Pilot Trial</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><description>Background. To study the feasibility of a response-guided therapy for chronic hepatitis C virus (HCV) infection in patients coinfected with human immunodeficiency virus (HIV) in a tertiary care hospital. Methods. Treatment duration was individualized on the basis of week 4 and week 12 virologic response. Sixty patients were enrolled and received pegylated interferon alfa-2b (1.5 μg/kg per week) plus weight-based ribavirin (800–1400 mg/day). Patients who achieved a rapid virologic response, defined as viral load <50 IU/mL at treatment week 4, completed 24 weeks of therapy. Patients who did not achieve a rapid virologic response were reassessed at treatment week 12. Patients with a complete early virologic response, defined as an HCV RNA level <600 IU/mL, were treated for 48 weeks. Patients with a partial response, defined as a decrease in the viral load ⩾2 log>10 and an HCV RNA level ⩾600 IU/mL, who attained an undetectable viral load at week 24 were treated for 60 weeks. The primary efficacy end point was sustained virologic response, defined as HCV RNA <50 IU/mL, 24 weeks after the end of treatment. Results. Overall, 33 (55%) of 60 patients achieved a sustained virologic response: 11 (44%) of 25 patients with HCV genotype 1, 3 (27%) of 11 patients with genotype 4, and 19 (79%) of 24 patients with genotype 3. One-third of patients showed a rapid virologic response. Of patients with genotype 1, there was a rapid virologic response in 4 (16%) of 25; with genotype 4, in 1 (9%) of 11; and with genotype 3, in 14 (58%) of 24. Of the 19 patients with a rapid virologic response, 17 (89.5%) eradicated the virus after 24 weeks of therapy. The rate of sustained virologic response was significantly higher among patients with genotype 3 and low pretreatment HCV RNA levels. A high relapse rate (46%) after 48 weeks of therapy occurred among patients infected with genotypes 1 or 4 who first achieved undetectable viral load at treatment week 12. Conclusion. A response-guide therapy is feasible and may be useful to optimize the individual outcome of HCV treatment in patients coinfected with HIV.</description><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Antiviral Agents - adverse effects</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Chi-Square Distribution</subject><subject>Chronic hepatitis</subject><subject>Feasibility</subject><subject>Female</subject><subject>Genotype</subject><subject>Genotypes</subject><subject>Hepacivirus - drug effects</subject><subject>Hepacivirus - genetics</subject><subject>Hepacivirus - isolation & purification</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatitis C virus</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - drug therapy</subject><subject>Hepatitis C, Chronic - virology</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV/AIDS</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Interferon-alpha - adverse effects</subject><subject>Interferon-alpha - therapeutic use</subject><subject>Interferons</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Pilot Projects</subject><subject>Polyethylene Glycols - adverse effects</subject><subject>Polyethylene Glycols - therapeutic use</subject><subject>Recombinant Proteins</subject><subject>Relapse</subject><subject>Ribavirin - adverse effects</subject><subject>Ribavirin - therapeutic use</subject><subject>Ribonucleic acid</subject><subject>RNA</subject><subject>RNA, Viral - blood</subject><subject>Statistics, Nonparametric</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Viral hepatitis</subject><subject>Viral Load</subject><subject>Virology</subject><subject>Viruses</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10GGLFCEYB_Ahiu666hsUFlSvpnRGR-3dsdTt0kJHbEvcG3GcZ1i3WZ3Uoe7b5zXLBkGvFP8_HvVfFE8JfkuwaN4xySnH94pzwmpeNkyS-3mPmSipqMVZ8SjGPcaECMweFmdEVpxRWZ0X7gvE0bsI5dVkO-jQZgdBj7eo9wEtdsE7a9ASRp1sshEt0NaGKaKV68Ek6x2yDl3nEFzKqbd_zvOYnzbt0HK1fY8u0bUdfEKbYPXwuHjQ6yHCk-N6UXz9-GGzWJbrz1erxeW6NFTQVLYYNyAliKqVAMzQVjAuK2BtVTegsdaEdW3PKQZKKGPGkLptDOkAt1jgqr4o3sxzx-B_TBCTOthoYBi0Az9FxRkjNLdAsnz5j9z7Kbj8OFURKRvCuczo9YxM8DEG6NUY7EGHW0Wwuutfzf1n-Pw4bWoP0P1lx8IzeHUEOho99EE7Y-PJ5QdV-T937sXs_DT-_7Jns9nH5MNJUVxjITnLeTnnNib4dcp1-K4aXnOmlt9uVCXXkmy2n9RN_Rtajq2S</recordid><startdate>20090415</startdate><enddate>20090415</enddate><creator>Van den Eynde, Eva</creator><creator>Crespo, Manuel</creator><creator>Esteban, Juan I.</creator><creator>Jardi, Rosend</creator><creator>Ribera, Esteban</creator><creator>Carbonell, Judit</creator><creator>Rodríguez-Frias, Francisco</creator><creator>Falco, Vicenç</creator><creator>Curran, Adrià</creator><creator>Imaz, Arkaitz</creator><creator>Villar del Saz, Sara</creator><creator>Ocaña, Inma</creator><creator>Esteban, Rafael</creator><creator>Pahissa, Albert</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope></search><sort><creationdate>20090415</creationdate><title>Response-Guided Therapy for Chronic Hepatitis C Virus Infection in Patients Coinfected with HIV: A Pilot Trial</title><author>Van den Eynde, Eva ; Crespo, Manuel ; Esteban, Juan I. ; Jardi, Rosend ; Ribera, Esteban ; Carbonell, Judit ; Rodríguez-Frias, Francisco ; Falco, Vicenç ; Curran, Adrià ; Imaz, Arkaitz ; Villar del Saz, Sara ; Ocaña, Inma ; Esteban, Rafael ; Pahissa, Albert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-b006e99e82b9ee5c4b85792e5b236ea0aa15dbf740e41455cc13b6c1de0b08023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Antiviral Agents - adverse effects</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Chi-Square Distribution</topic><topic>Chronic hepatitis</topic><topic>Feasibility</topic><topic>Female</topic><topic>Genotype</topic><topic>Genotypes</topic><topic>Hepacivirus - drug effects</topic><topic>Hepacivirus - genetics</topic><topic>Hepacivirus - isolation & purification</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Hepatitis C virus</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Hepatitis C, Chronic - drug therapy</topic><topic>Hepatitis C, Chronic - virology</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV/AIDS</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Interferon-alpha - adverse effects</topic><topic>Interferon-alpha - therapeutic use</topic><topic>Interferons</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Pilot Projects</topic><topic>Polyethylene Glycols - adverse effects</topic><topic>Polyethylene Glycols - therapeutic use</topic><topic>Recombinant Proteins</topic><topic>Relapse</topic><topic>Ribavirin - adverse effects</topic><topic>Ribavirin - therapeutic use</topic><topic>Ribonucleic acid</topic><topic>RNA</topic><topic>RNA, Viral - blood</topic><topic>Statistics, Nonparametric</topic><topic>Treatment Outcome</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Viral hepatitis</topic><topic>Viral Load</topic><topic>Virology</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van den Eynde, Eva</creatorcontrib><creatorcontrib>Crespo, Manuel</creatorcontrib><creatorcontrib>Esteban, Juan I.</creatorcontrib><creatorcontrib>Jardi, Rosend</creatorcontrib><creatorcontrib>Ribera, Esteban</creatorcontrib><creatorcontrib>Carbonell, Judit</creatorcontrib><creatorcontrib>Rodríguez-Frias, Francisco</creatorcontrib><creatorcontrib>Falco, Vicenç</creatorcontrib><creatorcontrib>Curran, Adrià</creatorcontrib><creatorcontrib>Imaz, Arkaitz</creatorcontrib><creatorcontrib>Villar del Saz, Sara</creatorcontrib><creatorcontrib>Ocaña, Inma</creatorcontrib><creatorcontrib>Esteban, Rafael</creatorcontrib><creatorcontrib>Pahissa, Albert</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van den Eynde, Eva</au><au>Crespo, Manuel</au><au>Esteban, Juan I.</au><au>Jardi, Rosend</au><au>Ribera, Esteban</au><au>Carbonell, Judit</au><au>Rodríguez-Frias, Francisco</au><au>Falco, Vicenç</au><au>Curran, Adrià</au><au>Imaz, Arkaitz</au><au>Villar del Saz, Sara</au><au>Ocaña, Inma</au><au>Esteban, Rafael</au><au>Pahissa, Albert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Response-Guided Therapy for Chronic Hepatitis C Virus Infection in Patients Coinfected with HIV: A Pilot Trial</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2009-04-15</date><risdate>2009</risdate><volume>48</volume><issue>8</issue><spage>1152</spage><epage>1159</epage><pages>1152-1159</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>Background. To study the feasibility of a response-guided therapy for chronic hepatitis C virus (HCV) infection in patients coinfected with human immunodeficiency virus (HIV) in a tertiary care hospital. Methods. Treatment duration was individualized on the basis of week 4 and week 12 virologic response. Sixty patients were enrolled and received pegylated interferon alfa-2b (1.5 μg/kg per week) plus weight-based ribavirin (800–1400 mg/day). Patients who achieved a rapid virologic response, defined as viral load <50 IU/mL at treatment week 4, completed 24 weeks of therapy. Patients who did not achieve a rapid virologic response were reassessed at treatment week 12. Patients with a complete early virologic response, defined as an HCV RNA level <600 IU/mL, were treated for 48 weeks. Patients with a partial response, defined as a decrease in the viral load ⩾2 log>10 and an HCV RNA level ⩾600 IU/mL, who attained an undetectable viral load at week 24 were treated for 60 weeks. The primary efficacy end point was sustained virologic response, defined as HCV RNA <50 IU/mL, 24 weeks after the end of treatment. Results. Overall, 33 (55%) of 60 patients achieved a sustained virologic response: 11 (44%) of 25 patients with HCV genotype 1, 3 (27%) of 11 patients with genotype 4, and 19 (79%) of 24 patients with genotype 3. One-third of patients showed a rapid virologic response. Of patients with genotype 1, there was a rapid virologic response in 4 (16%) of 25; with genotype 4, in 1 (9%) of 11; and with genotype 3, in 14 (58%) of 24. Of the 19 patients with a rapid virologic response, 17 (89.5%) eradicated the virus after 24 weeks of therapy. The rate of sustained virologic response was significantly higher among patients with genotype 3 and low pretreatment HCV RNA levels. A high relapse rate (46%) after 48 weeks of therapy occurred among patients infected with genotypes 1 or 4 who first achieved undetectable viral load at treatment week 12. Conclusion. A response-guide therapy is feasible and may be useful to optimize the individual outcome of HCV treatment in patients coinfected with HIV.</abstract><cop>Oxford</cop><pub>The University of Chicago Press</pub><pmid>19275492</pmid><doi>10.1086/597470</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical infectious diseases, 2009-04, Vol.48 (8), p.1152-1159 |
| issn | 1058-4838 1537-6591 |
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| source | Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Analysis of Variance Antiviral Agents - adverse effects Antiviral Agents - therapeutic use Biological and medical sciences Chi-Square Distribution Chronic hepatitis Feasibility Female Genotype Genotypes Hepacivirus - drug effects Hepacivirus - genetics Hepacivirus - isolation & purification Hepatitis Hepatitis C Hepatitis C virus Hepatitis C, Chronic - complications Hepatitis C, Chronic - drug therapy Hepatitis C, Chronic - virology HIV HIV Infections - complications HIV/AIDS Hospitalization Hospitals Human immunodeficiency virus Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infections Infectious diseases Interferon-alpha - adverse effects Interferon-alpha - therapeutic use Interferons Male Medical sciences Middle Aged Patients Pilot Projects Polyethylene Glycols - adverse effects Polyethylene Glycols - therapeutic use Recombinant Proteins Relapse Ribavirin - adverse effects Ribavirin - therapeutic use Ribonucleic acid RNA RNA, Viral - blood Statistics, Nonparametric Treatment Outcome Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral hepatitis Viral Load Virology Viruses |
| title | Response-Guided Therapy for Chronic Hepatitis C Virus Infection in Patients Coinfected with HIV: A Pilot Trial |
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